Pharmacists to vote on working to rule

 The National Pharmacy Association (NPA) is balloting its members on working to rule amid growing concerns over funding and budget cuts, it has announced today.

If passed, thousands of pharmacies across England, Wales and Northern Ireland could take collective action before Christmas, in an unprecedented move for the sector.

The ballot, which will be sent to NPA members ‘within days’, asks pharmacies if they will reduce services, withdraw free deliveries or free medicine dispensing packs, and put NHS leaders on notice that they will cut their hours to contract minimums ‘if the financial situation for the sector does not improve’.

The NPA says that a £1.3 billion funding increase in England is needed ‘to plug the financial blockhole facing community pharmacies’.

Pharmacies will also be asked if they will boycott data collection beyond that required in their contract and consider serving notice on a range of locally contracted services, negotiated directly with local authorities.

A motion included in the ballot reads: ‘Community pharmacies are committed to providing a safe service. But our ability to provide that safe provision will soon be put at risk by continued declining funding, mass pharmacy closures and growing workloads.

‘We are putting the NHS leaders on notice that we cannot guarantee community pharmacy services will remain safe into the future if current depressed funding, pharmacy closures and increasing workload trends continue.’

NPA members will have six weeks to respond.

Paul Rees, NPA chief executive, said the organisation ‘desperately’ wants to work with the new government ‘to unleash the vast potential of pharmacies to deliver the better health in the community that we all want’.

‘But despite big settlements for junior doctors and train drivers since the election there is no sign – as yet – of an end to the chronic real terms cuts that is literally driving dedicated healthcare professionals in pharmacies out of business,’ he said.

‘It pains us to take this step but pharmacies are being pushed to the brink by a decade of real terms cuts that has slashed 40% from their funding.

‘Pharmacies are routinely required  to dispense NHS medicines at a loss, 1,500 have been forced to close in the past decade, while others have had to cut hours to try and make ends meet. That is not acceptable and is hitting patients hard,’ he said.

He told Pulse’s sister title The Pharmacist that the NPA had shared its plans for potential action with all four national negotiating bodies.

But he said that it was not currently balloting members in Scotland.

‘In terms of of the other nations, I think community pharmacy teams would say that they feel that the amount of support they’re getting from the the NHS in those nations is simply insufficient,’ Mr Rees said.

Many GP practices are currently ‘working to rule’ under collective action organised by the British Medical Association (BMA). This could include limiting each clinician’s daily appointments and refusing to engage with unfunded pathways.

Mr Rees said that the BMA’s position as both a negotiator, campaigner and organiser of collective action gave general practice ‘a lot of muscle in the space of negotiating with government’.

‘We have a different setup in community pharmacy, so our aim as a National Pharmacy Association is to campaign and to be the voice of the sector and to strengthen the hand of the negotiator,’ he told The Pharmacist.

The sector in England is currently awaiting negotiations on the current financial year’s contractual arrangement to commence ‘soon’.

Community pharmacy leaders have described the delay to the contract as ‘frustrating’ and ‘ridiculous’. And contractors have said they are struggling to operate on a funding deal agreed more than five years ago.

Community Pharmacy England (CPE) has revealed that it is looking to ensure that Pharmacy First funding is included within the core community pharmacy contract. It also wants to see funding uplifted for inflation, an increase in activity and service expansion.

Speaking at the Avicenna Heathrow conference earlier this month (8 September), both CPE and NPA leaders said that ‘working to rule’ and legal action against the government remained a possibility for the sector.

Since the NPA is not a trade union, any ballot outcome will be advisory, it has confirmed.

The announcement comes as the NPA conducts its second ‘day of action’, which aims to highlight the issue of dispensing medicines at a loss.

Pharmacists will also be asked to record any unpaid advice they give to patients, and will ask patients to sign a cross-sector petition of support, which has now surpassed 350,000 signatures.

Community pharmacy teams may also sound an alarm between 9.00am and 9.02am, to highlight the emergency of the situation.

And they might repeat some actions from the previous day of action on 20 July, such as wearing black, blacking out windows and turning out the lights.

‘We feel that what politicians who are arguing for a new deal for community pharmacy want, is us to make a noise so that the Treasury feels minded to release the purse strings,’ Mr Rees told The Pharmacist.

‘There are so many calls on the public purse at the moment, so that’s why we feel that the second day of action is critical, and the ballot on working to rule,’ he added.

Responding to the NPA’s plan to ballot its members, a Department of Health and Social Care (DHSC) spokesperson said: ‘This government inherited a broken NHS where pharmacies have been neglected for years.

‘Pharmacies are key to making healthcare fit for the future as we shift the focus of the NHS out of hospitals and into the community. We will make better use of pharmacists’ skills, including accelerating the rollout of independent prescribing to improve access to care.’

A version of this story was first published by Pulse’s sister title The Pharmacist